Comparative evaluation of the effect of impregnated retraction cord versus laser on gingival attachment level and pain perception following retraction for subgingival margins - A prospective, split-mouth, controlled, clinical study.

AIM: To evaluate and compare the effect of impregnated retraction cord vs Laser on gingival attachment level and pain perception following retraction for subgingival margins. SETTINGS AND DESIGN: Many methods for achieving and measuring the amount of gingival retraction in fixed prosthodontic work have been advocated. Though the gingival attachment level is crucial in Periodontology, the literature available regarding the effect of these retraction methods on the same is scarce. Hence, this clinical study was designed to compare the pain perception and amount of gingival recession when impregnated cord and laser were used for retraction. MATERIALS AND METHODS: In 40 subjects (age range of 20 to 40 years) with single missing maxillary incisor, the abutments were prepared with subgingival margins, to receive a full coverage metal-ceramic fixed dental prosthesis. The gingiva was retracted on one of the abutments with impregnated retraction cord and on the other with diode laser. Gingival attachment levels were compared at six sites per abutment using superimposition of digital scans, preoperative and four weeks after cementation of final prosthesis. STATISTICAL ANALYSIS USED: Statistical analysis of the data for gingival recession was done using t-test. Pain perception was analysed with Chi-square test. Pain perception by patients following retraction was compared with VAS scale. RESULTS: The average values of gingival recession on buccal side were 0.61 mm and 0.38 mm and on the palatal side were 0.58 mm and 0.35 mm for impregnated retraction cord and laser respectively. The P values of <0.01 indicated a highly significant difference between the two groups. Intragroup comparison did not show significant differences between various sites. Pain and discomfort produced by cord method was moderate in comparison with mild/no pain with diode laser and the difference was highly significant.Conclusion: Retraction cord produced more gingival recession than the diode laser, which was statistically highly significant on both buccal and palatal aspects of the teeth. Patients experience with diode laser technique was less painful in comparison with retraction cord method.

A Clinical Comparative Evaluation Of The Wear Of Enamel Antagonist To Monolithic Zirconia And Metal-Ceramic Crowns.

PURPOSE: To evaluate and compare the wear of natural enamel against a metal-ceramic and a monolithic zirconia crown, with the null hypothesis that there is no difference in the wear of enamel between antagonist metal-ceramic and monolithic zirconia crowns. MATERIALS AND METHODS: In 30 subjects (irrespective of sex and within the age range of 18 to 40 years), two bilaterally opposing molars (maxillary/mandibular) were prepared to receive monolithic zirconia or metal-ceramic crowns with feldspathic porcelain veneer. A polyvinyl siloxane impression of the opposing arch was taken at the time of cementation and 1 year after cementation. Casts were poured in type III gypsum and scanned, and the images were superimposed on each other. AutoCAD was used to calculate the difference between two images, which corresponded to the linear wear of the antagonist teeth. Statistical analysis of the data was done using one-way analysis of variance (ANOVA) and post hoc Tukey honest significant difference test for intergroup comparison. The P value obtained by one-way ANOVA was 1.1102e-16 (< .05), and by post hoc Tukey test was .001 (< .01). RESULTS: The mean wear of enamel against enamel was 14.8 ± 1.3 µm, enamel against metal-ceramic was 87.1 ± 18.3 µm, and enamel against monolithic zirconia was 59.4 ± 13.6 µm. The P values obtained; ie, 1.1102e-16 (one-way ANOVA) and 0.001 (post hoc Tukey), indicated that the difference in wear of the antagonist tooth between monolithic zirconia and feldspathic porcelain was significant. CONCLUSION: It can be concluded that monolithic zirconia causes less wear of the antagonist tooth than feldspathic porcelain.

Evaluation of the relation of maxillary canine and edge of central incisor to incisive papilla in Indian population with respect to arch form.

Finding the most suitable position for artificial anterior teeth in the absence of pre-extraction records presents a new challenge with every denture and has resulted in a variety of measurements. It encompasses the knowledge of anatomy and physiology of oral tissue. In this study, the relation between anatomical landmarks the tips of the maxillary canines, edge of central incisor and center of incisive papilla was evaluated and compared with respect to arch form in Indian population. Arch forms were accessed by their morphological description as square, tapering or ovoid arch. Measurements on the casts were recorded for incisive papilla and maxillary central incisor distance, by digital vernier caliper and photographic technique was used to record the relation between tips of the canine and the centre of the incisive papilla. The mean distance between edge of central incisor to center of incisive papilla for square arch, oval arch and tapered arch was found as 9.667, 9.991 and 10.912 mm respectively. When all the 300 casts were taken together, it indicated that 51.3 % of intercanine lines passed through the center, 18.1 % of inter canine lines passed posterior and 30.6 % of the intercanine lines passed anterior to the center of incisive papilla. χ(2) (Chi square) values concluded they differ significantly and significant number of intercanine lines crossed through the center of the incisive papilla irrespective of the arch form.

Presurgical management of unilateral cleft lip and palate in a neonate: a clinical report.

A cleft lip and palate consists of fissures of the upper lip and/or palate, and is the most commonly seen orofacial anomaly that involves the middle third of the face. Early treatment of patients with a cleft lip and palate is important because of esthetic, functional, and psychological concerns. Nasoalveolar molding provides excellent results when started immediately after birth. This clinical report describes the presurgical management of an infant with a complete unilateral cleft of the soft palate, hard palate, alveolar ridge, and lip.